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KMID : 0359720160340020124
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Journal of the Korean Neurological Association
2016 Volume.34 No. 2 p.124 ~ p.129
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Clinical Characteristics of REM-Dependent Obstructive Sleep Apnea in Korean Adults
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Moon Hye-Jin
Lim Sang-Hun
Kim Do-Hyung
Kim Dong-Eun
Hwang Sang-Hee
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Abstract
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Background: Rapid-eye-movement-sleep-dependent obstructive sleep apnea (REM-OSA) is a sleep breathing abnormality in which apneas/hypopneas occur mainly during REM sleep periods. However, the clinical significance of REM-OSA compared to sleep-stage-non-dependent OSA (SND-OSA) has been controversial. This study evaluated differences in the clinical features, polysomnography (PSG) characteristics, and subjective symptoms between REM-OSA and SND-OSA.
Methods: In total, 136 consecutive patients with mild-to-moderate OSA were enrolled. REM-OSA was defined as a rapid eye movement (REM):non-REM apnea-hypopnea index (AHI) ratio of ＞2 and a total duration of REM sleep exceeding 30 minutes. We compared the demographic, clinical, and PSG characteristics, and subject symptoms between REM-OSA and SND-OSA.
Results: The REM-OSA group comprised 45 (33%) of the 136 subjects. The mean age and total AHI did not differ between the groups, but there was a significant female predominance (35.6% vs. 16.5%) in the REM-OSA group. In terms of PSG parameters, subjects with REM-OSA showed a lower percentage of light sleep and a lower AHI in a supine position despite spending more sleep time in that position. Subjective sleep complaints, depression, anxiety, and health-related quality of life did not differ between the two study groups.
Conclusions: The female predominance and sleep architecture differed between REM-OSA and SND-OSA in this study. The AHI in subjects with SND-OSA was dependent on sleep position rather than sleep stage. Further study is needed to elucidate the pathomechanism and clinical significance of REM-OSA.
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KEYWORD
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REM-dependent OSA, REM-related OSA, REM-dependent sleep apnea, REM sleep, Obstructive sleep apnea, Polysomnography
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